Nursing Innovation & Best Practices Forum

1. Midatlantic Presenters: Bryan Overman, Regional Nurse Director Jaclynn Haymon, Clinical Innovation & Optimization Consultant April 21, 2016 The Voice of NursingCommunity of Practice ForumPam Jensen, NPCSSenior Project Manager

2. Voice of Nursing Community of Practice Forum Monthly interactive forum for Kaiser Permanente teams, facilities and/or regions to share their on-going activities, best practices and challenges to: • Embed the Kaiser Permanente Nursing Vision, Values, and Professional Practice Model • Drive nursing professional practice goals • Improve patient outcomes Learn from others, get new innovative ideas, identify potential obstacles to speed and spread your own process Presentation slides will be posted on the Nursing Pathways website. To minimize noise, please put yourself on mute during the presentations. Do not place the call on hold.

3. The Voice of NursingCommunity of Practice Forums (CoP) Forums Mid Atlantic States April 21, 2016 Bryan Overman, MA, RN, FACHE and Jaclynn Haymon, MPA, RN

4. With the largest multi-specialty physician group practice in the region, supported by state-of-the-art technology, Kaiser Permanente offers our members superior quality, market-leading convenience, and the most highly coordinated care in the Mid-Atlantic. • Fast facts: • Located in the District of Columbia, Maryland and Virginia • 654,000 members, including 124,000 Federal enrollees • Nearly 1,100 Mid-Atlantic Permanente Medical Group physicians • 1600 Nurses • 6,000 plus employees • 33 medical facilities • 24 hours/7 days /365 days care available • No Hospitals – Core and Non-Core Contracted Hospitals

5. 4 Our Hub Strategy Baltimore Open! - Gaithersburg Medical Center Open!- Baltimore Medical Center Open!- Largo Medical Center Open! - Tyson’s Corner Medical Center PG, Calvert, Charles Open! – Capitol Hill Medical Center Hub Current Facility Northern Virginia

6. Regional Committees/Initiatives Led by Nursing Quality Initiatives/Programs • Critical Events Workgroup Safety Initiatives/Programs • Clinic Medication Safety • Great Catch Program “ Just Culture” Flu Committee Nursing Research Committee Scope of Practice Committee New Employee Orientation Sharps Safety Workgroup Nursing Grand Rounds

7. Voice of Nursing June 2015 NPCS facilitated VON at KPMAS Brought together 30 nursing and stakeholder departments (front line RNs, nurse managers/director, pharmacy, rehabilitation, laboratory) representatives, Vice Presidents and Health Plan President Steering Committee created ambitious strategy and aligning work plan to enhance nursing professional practice-from concept to reality over the next 2 ½ years Met via webex several times following the in person meeting to review the submitted action plan and set priorities Education and Inspiration work groups were prioritized for the first 6 months following the June meeting Engaged in behind the scene meetings with regional senior executive team to address long term infrastructure needs and changes

8. Our Kaiser Mid Atlantic States VON Team

9. June Voice of Nursing Meeting ADD Pictures

10. Education Workgroup Priorities Identify labor, management, and physician champions and educate and inform about VON Evaluation: Successfully recruited physician, management, and 1 of 2 union champions Educate and inform front line nurses about VON through individual MOB events • Completed approximately 40 MOB engagements from January-April 2016. Including non-traditional MOB (partnering hospitals, call centers) • Goal: Tie concept of VON directly to nursing professional practice and nursing ownership (ANA Code of Ethics, Scope & Standards, KP Nursing Vision, Continuing Education & Ben Hudnall, nursing research, nursing story table) Evaluation: 40% of 1600 nurses attended a VON face to face event Develop & deploy professional practice survey to the RNs • Understand their nursing professional practice needs Evaluation: 60 completed surveys

11. PIC of VON Event

12. Education Workgroup Current/Future Priorities Capture remaining nurses to socialize VON • Nursing Grand Rounds • New Nursing Practice newsletter • Nurses Week luncheon Increase nursing professional practice response rate through email reminders, column in newsletter and nursing competency sessions Develop and deploy professional based nursing competencies • Move pendulum from task-based starts 2016 • 2016 Core Nursing Competencies: Evidence-based practice, Leadership, working in a “Just Culture” Establish a Nursing Professional Practice Council • New Grad RN Residency Program workgroup Incorporate VON elements in nursing new employee orientation-complete

13. Inspiration Workgroup Priorities Educate & Inform leadership and front line RNs about the National Nurse Recognition Programs • Extraordinary Nurse Award and Daisy Award Programs Deploy and receive nominations for the two recognition programs Evaluation: Received 33 nominations for Extraordinary Nurse Program. Submitted 9 nominations. Award winner for first time. 11 nominations from physician colleagues Create a Patient Care Services Recognition Council • Define process and review submissions Evaluation: Seated council. Reviewed Extraordinary Nurse submissions. Discussed Daisy Awards. Socialize concept of nurses sharing their personal stories; collect and disseminate these stories with nursing, clinical colleagues, leadership, and members Evaluation: Collected 150 stories

14. Inspiration Current Work • Nurses Week 2016 • Partnership with Corporate Communications • Disseminate Nurse Stories (social media), posters • Utilize multiple communications streams to recognize all nurses nominated for Extraordinary Nurse Award • Announce Participation in Daisy Awards

15. Infrastructure Workgroup Priorities Agreement with executive leadership (COO, VPs) to tie infrastructure work to larger goal of the journey towards Magnet designation • Graduate student intern conducted initial infrastructure crosswalk against Magnet requirements • Evaluation: Crosswalk complete. Creating action plan to address gaps Majority of this work to start 2016-2017 Standardize life cycle of employee • Review job descriptions to ensure nursing values are incorporated • Develop hiring evaluation tool (incorporates ANA nursing values) • Develop in partnership with HR exit interview for nursing **Develop and provide tools for leaders to enculturate professional practice with staff Redesign RPCS page Update onboarding tools that incorporate ANA and KP nursing values

16. Evaluation Workgroup Priorities Create a nursing professional practice dashboard Track highest level of educational Track number of nurses with professional certifications Track number of nurses that belong to a professional organization Evaluate socialization of Nurse Recognition Programs Evaluation: Established benchmark for Extraordinary Nurse Award submissions. Will establish benchmarking for Daisy Awards and Nursing Pin nomination submissions in 2016 Nurse professional practice survey is one of the method to anonymously collect data on education, certifications, and participation in professional organizations

17. Knowledge Translation Steering Committee has begun brainstorming ways to ingrain the concept of VON & nursing professional practice and translate it to higher degree of clinical nursing practice 2016 nursing core competencies topics address 3 of 4 KP nursing pillars- Quality and Safety, Leadership, and Research/EBP • Nursing core competencies are mandatory and in-person Revisit the core 2015 nursing competencies (critical thinking) in the nursing newsletter with scenario questions • Recommend nurse managers review during staff meetings Nursing Research Committee~ launched Jan 2016 • Monthly series of webinars for nurses to describe nursing research • Introduction to the basics-Clinical Library Part 1 • Literature reviews, systematic reviews, and Clinical Library EBP • Formulating a research question and hypothesis – Clinical Library Database Searching • Understanding quantitative research designs

18. What We Have Learned…. Identify your champions. Spell out how you need them to be involved. Provide options for them to participate Capitalize on timing. VON came at the perfect time • Clinical Assistant Skills Max Program • Perception of the role of the RN in the ambulatory setting eroding • Tied message of VON-Professional Practice, and 2016 and 2017 as the year of the nurse, together Purposely spent two months planning the education roll out. Mapped out the 35+ MOBs. Education workgroup wanted the events to be fun, interactive, and provide space for networking Biggest challenge to date: Capturing the evaluation data when it’s not mandatory

19. What We Need Help With… • What successfully strategies have other facilities employed to translate the work of VON to higher levels of nursing practice? • How have other facilities tracked education level, participation in professional organizations, etc?

20. Q & A